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PubMed1995

Force and moment distributions among osseointegrated dental implants.

Distributions of force, bending moment and torque are determined by structural analysis for an osseointegrated dental implant system. The system is a dental prosthesis rigidly connected to bone by implants. Since the implants have the lowest flexural rigidity of the structural components, they are considered to be the only elastic components of the system. In the analysis, the number and position of the implants are variable and the magnitude, direction and location of the applied load are arbitrary. The distributions found by force and moment balances are in the form of simple algebraic equations, a form which is useful for clinicians in determining the number and location of implants so that forces and moments are shared equitably. One immediate result of the structural analysis is that the bending moment due to the vertical component of the applied load--a moment which has previously been neglected--can produce stresses in the implant which are an order of magnitude larger than the direct axial stresses.

Biomechanical Phenomena↗
PubMed1991

Dental implant design--effect on bone remodeling.

Bone remodeling around three different endosseous dental implant designs placed in dog mandibles was studied using radiography during lengthy periods of function and by histology after animal sacrifice. The three designs investigated were (a) threaded (c.p. titanium), (b) fully porous-coated (titanium alloy), and (c) partially porous-coated (titanium alloy). The implants were kept in function for either 32 weeks (fully porous-coated) or 73 to 77 weeks (partially porous-coated and threaded). The studies indicated that some crestal bone loss occurred for both the threaded and partially porous-coated implants while no significant bone loss was seen with fully porous-coated implants in the absence of plaque-associated infection. It is suggested that these observed differences are a result of the different stress states that develop in bone surrounding the three designs underlying the importance of implant design on bone remodeling.

Alveolar Process↗
PubMed1992

Dental implants to rehabilitate a patient with an unrepaired complete cleft of the hard and soft palate: a clinical report.

Prosthetic rehabilitation of an edentulous adult with a complete residual cleft of his palates is presented. Lack of retention of his prosthesis made speech and eating difficult. Four osseointegrated dental implants were used to join the right and left maxillae and to provide mechanical retention for a complete overdenture obturator to improve function.

Cleft Palate↗
PubMed2000

A 5-year prospective clinical and radiographic study of non-submerged dental implants.

Osseointegrated implants as anchors for various prosthetic reconstructions have become a predictable treatment alternative. It was expected that implants required submucosal placement during the healing period for successful tissue integration. However, it has been demonstrated that healing and long-term health of implants could be achieved with equal predictability in a 1-stage, non-submerged approach. This prospective 5-year study not only calculates implant success by life table analysis, but also evaluates the correlation between observed bone level changes with clinical parameters as measured by suppuration, plaque indices, bleeding indices, probing depth, attachment level and mobility. A total of 112 ITI dental implants were inserted in different areas of the jaws. Clinical and radiographic parameters were evaluated annually for 5 years, whereas a portion of the study group for which 6-year evaluations were available were included in the life-table analysis. The overall success rate after 5 years in service was 99.1%, while after 6 years it was reduced to 95.5% due to the fracture of 3 implants in 1 patient. The mean crestal bone loss experienced during the first year was 0.6 mm followed by an annual yearly loss of approximately 0.05 mm. No significant differences could be found between the amount of bone loss measured at each of the yearly follow-up visits. This suggests that statistically the followed implants did not show any radiographically measurable bone loss following the initial period of bone loss associated with implant placement and osseointegration. Low levels of correlation between the individual and cumulative clinical parameters with radiographically measured bone loss suggests that these parameters are of limited clinical value in assessing and predicting future peri-implant bone loss.

Alveolar Bone Loss↗
PubMedDate not supplied

A comparison of three-dimensional finite element stress analysis with in vitro strain gauge measurements on dental implants.

PURPOSE: The purpose of this study was to evaluate the compatibility of three-dimensional finite element stress analysis and in vitro strain gauge analysis in the measurement of strains on a dental implant. MATERIALS AND METHODS: Two vertically placed implants embedded in a poly(methyl methacrylate) model were used. Strain gauges were bonded to the cervical parts of the implants, and seven cement-retained fixed partial dentures were fabricated. A three-dimensional model of the strain gauge analysis model was constructed, and an additional model in which human bone simulation was provided was also constructed. A static vertical load of 50 N was applied at certain locations to simulate centrally positioned axial and laterally positioned axial loading for strain gauge analysis and three-dimensional finite element stress analysis. RESULTS: Statistically significant increases in strain levels were recorded between loading types in the strain gauge analysis (P < .05). Strains obtained from strain gauge analysis were higher than for three-dimensional finite element stress analysis. There was a remarkable difference between the two finite element models under the conditions of laterally positioned axial loading. CONCLUSION: There are differences regarding the quantification of strains between strain gauge analysis and three-dimensional finite element stress analysis. However, there is a mutual agreement and compatibility between three-dimensional finite element stress analysis and in vitro strain gauge analysis on the determination of the quality of induced strains under applied load.

Analysis of Variance↗
PubMed1995

Clinical evaluation of guided bone regeneration at exposed parts of Brånemark dental implants with and without bone allograft.

This investigation evaluated guided bone regeneration with a polytetrafluoroethylene barrier membrane at exposed parts of Brånemark dental implants with and without concomitant use of decalcified freeze-dried bone allograft. Density of the regenerated tissue was also determined using a No. 23 probe at a pressure of 25 g and was graded from 1 to 5. The higher index was associated with a higher resistance of newly formed tissue to the pressure of the probe. In 19 patients, 23 defects were treated by barrier membrane alone and 11 defects by bone allograft with barrier membrane. The width and the depth of the defects were determined at the time of the implant placement and at the second-stage implant surgery. When success was defined as 0 mm of residual defect, the mean success rate was 68% for the membrane group and 90% for the membrane group with bone allograft, with no statistically significant difference between the two treatment groups. The two groups did not demonstrate a significant difference in median density index. There was a significant positive relationship between time of membrane coverage and density index. A density index of 4 was only recorded after 7 months of membrane coverage. The present findings suggest beneficial clinical effect with the use of membrane alone and freeze-dried bone allograft with membrane for guided bone regeneration. This study proposed the use of a novel density index for clinical evaluation of regenerated tissue.

Adult↗
PubMed1999

Clinical and radiographic evaluation of early loaded free-standing dental implants with various coatings in beagle dogs.

STATEMENT OF PROBLEM: Immediate loading of implants may be a predictable treatment alternative when cross-arch stabilization with a fixed provisional is observed. PURPOSE: This study investigated the effect of immediate masticatory loading on the stability of single-standing dental implants with 4 different surfaces. MATERIAL AND METHODS: A total of 40 solid screw implants (diameter 3.3 mm, length 8 mm) were placed in the mandibles of 4 beagle dogs. Test groups included 3 hydroxyapatite (HA) coatings of titanium plasma-sprayed (TPS) implants. Implants with TPS alone served as control. Gold crowns were inserted 2 days after implant placement and the dogs were immediately put on a hard food diet. Implants were followed for 6 months after loading. Clinical and radiographic assessments of implants were performed at time of crown insertion (baseline) and after 1, 3, and 6 months of loading. The Periotest instrument was used for mobility measurements and radiographs were obtained for evaluation of peri-implant radiolucency and measurement of crestal bone changes. RESULTS: Of 40 implants, 39 displayed no discernible mobility, corresponding to successful clinical function. Peri-implant radiolucencies were absent for all but the 1 mobile implant. The reduction in crestal bone levels adjacent to the implants between baseline and 6 months was statistically significant (P <.0001). No statistically significant differences in crestal bone level changes over time were found between the various coatings demonstrating the absence of a treatment effect initiated by the surface coatings. CONCLUSION: In this study in beagle dogs, immediate masticatory loading of single-standing dental implants did not jeopardize tissue integration, provided the implants had excellent primary stability.

Analysis of Variance↗
PubMed2006

Assessment of correlation between computerized tomography values of the bone, and maximum torque and resonance frequency values at dental implant placement.

The aim of this study was to determine the bone density in the designated implant sites using computerized tomography (CT), the fastening torque values of dental implants, and the implant stability values using resonance frequency analysis. Further aim was to evaluate a possible correlation between bone density, fastening torque and implant stability. Eighty-five patients were treated with 158 Brånemark System implants. CT machine was used for preoperative evaluation of the jawbone for each patient, and bone densities were recorded in Hounsfield units (HU). The fastening torque values of all implants were recorded with the OsseoCare equipment. Implant stability measurements were performed with the Osstell machine. The average bone density and fastening torque values were 751.4 +/- 256 HU and 39.7 +/- 7 Ncm for 158 implants. The average primary implant stability was 73.2 +/- 6 ISQ for seventy implants. Strong correlations were observed between the bone density, fastening torque and implant stability values of Brånemark System TiUnite MKIII implants at implant placement (P < 0.001). These results strengthen the hypothesis that it may be possible to predict and quantify initial implant stability and bone quality from pre-surgical CT diagnosis.

Adult↗
PubMed2001

Measurement of the setting and thermal expansion of dental investments used for the superplastic forming of dental implant superstructures.

OBJECTIVES: The study examined the setting and thermal expansions of seven dental casting investments intended for use in the superplastic forming (SPF) of Ti6A14V for dental implant superstructures. The total expansion is compared with the coefficient of thermal expansion of the alloy. METHODS: The unrestricted setting expansion of the investment was measured at room temperature using a lined brass trough and dial gauge. The thermal expansion was measured at a heating rate of 5 degrees C/min up to 900 degrees C. The thermal expansion of Ti6A14V was measured at a heating rate of 15 degrees C/min. RESULTS: The Selevest investment had a small shrinkage on setting. The largest setting expansions were observed with Rema Exakt and Fujivest. Selevest DM and Fujivest had the greatest thermal expansions. Rema Exakt had the greatest overall expansion. The total expansion of Rematitan most closely matched the thermal expansion of Ti6A14V when the manufacturer's recommended special liquid to water ratio for crowns and bridges was used. SIGNIFICANCE: SPF is a novel technique which is being applied to the manufacture of dental prostheses. As dental casting investments are used to make the dies used for SPF the dimensional changes associated with these materials should be matched to the dimensional changes of the Ti6A14V alloy used in order to achieve a passive fit. This study has identified Rematitan as an investment whose total expansion may enable an accurately fitting SPF implant superstructure to be made.

Algorithms↗
PubMed2002

[Early dental implantation using brephobone allotransplants].

The installation of titanic screw two-stage dental implants and simultaneous alveolar ridge plasty with demineralizated lyophilizated bone allografts was performed in early terms--3-17 weeks after the tooth extraction. The tissue shaving picked under the implant bed preparation was exposed to histology analysis to determine the initial conditions for early implantation. 23 patients were operated on and 41 implants were installed. The successful osteointegration was reached in 95.1% cases. The full restoration of bone density and thickness after complete treatment was confirmed by computer tomography.

Adult↗
PubMed2004

Navigation surgery for dental implants: assessment of accuracy of the image guided implantology system.

PURPOSE: The purpose of this study is to assess the accuracy of the navigation provided by the Image Guided Implantology system (DenX Advanced Dental Systems, Moshav Ora, Israel), which was designed to guide the surgeon in the placement of dental implants. MATERIALS AND METHODS: Seven jaw models incorporating special ceramic spheres were imaged by dental computerized tomography. The coordinates of these reference ceramic markers were calculated by the Image Guided Implantology and compared with their actual position coordinates as identified on the computed tomography image. RESULTS: The overall mean spatial navigation error was 0.35 +/- 0.14 mm. The 1-tailed probability of any single measurement exceeding 0.75 mm was less than 0.003, and that exceeding 1 mm was less than 0.0001. CONCLUSION: The Image Guided Implantology system provides highly accurate navigation with less than 0.73 mm error, which is acceptable in dental implantology. The accurate reporting of the exact position of the drilling bur should minimize the potential risk of damage to critical anatomic structures. The accurate intraoperative navigation allows the surgeon to precisely transfer the presurgical plan to the patient.

Ceramics↗
PubMed1999

Immediate functional loading of Brånemark dental implants. An 18-month clinical follow-up study.

A clinical and radiographical study was performed to compare the outcome of oral rehabilitation in the edentulous mandible by fixed supraconstructions connected to implants installed according to either i) a 1-stage surgical procedure and immediate loading (Experimental Group-EG), or ii) the original 2-stage concept (Reference Group-RG). The EG comprised 16 subjects with edentulous mandibles. Beyond the non-smoking criteria the following specific inclusion criteria were adopted: i) all patients had to consider themselves to be in good general health, ii) the amount of bone had to enable the installation of 5-6, at least 10 mm long fixtures to be bicortically anchored (Mk II fixtures; Nobel Biocare AB, Göteborg, Sweden) between the mental foramina, and iii) the patients had to be available for the follow-up and maintenance programme. A total of 88 implants were placed in the EG (16 patients) compared to 30 in the RG (11 patients). In the EG, fixed appliances were connected to the implants within 20 days following implant installation while the fixed appliances in the RG were connected about 4 months following fixture installation. At the time for delivery of the supraconstructions all 27 patients were radiographically examined, an examination that was repeated at the 18-month follow-up. The analysis of the radiographs from the EG disclosed that during the 18-month observation period the mean loss of bone support amounted to 0.4 mm. The corresponding value observed in the RG was 0.8 mm. During the 18-month observation period no fixture was lost in any of the 2 groups examined. The implants under study as well as those in the reference material were at all observation intervals found to be clinically stable. The present clinical study demonstrated that it is, at least based on an 18-month observation period, possible to successfully load titanium dental implants immediately following installation via a permanent fixed rigid cross-arch supraconstruction. However, such a treatment approach has so far to be strictly limited to the inter-foramina area of the edentulous mandible.

Aged↗
PubMed2000

Early functional loading of Brånemark dental implants: 5-year clinical follow-up study.

BACKGROUND: Short-term clinical studies have indicated the possibility of one-stage surgery and early loading of machined titanium implants. However, long-term data comparing the outcome to the conventional two-stage technique are missing. PURPOSE: A clinical and radiographic study was performed to compare the outcome of oral rehabilitation of the edentulous mandible by fixed suprastructures connected to implants installed according to either (1) a one-stage surgical procedure and early loading (experimental group--EG) or (2) the original two-stage concept (reference group--RG). The EG and RG comprised 16 and 11 subjects, respectively. MATERIALS AND METHODS: The following specific inclusion criterion were adopted: (1) all patients had to consider themselves to be in good general health, (2) the amount of bone had to enable the installation of five to six, at least 10-mm long fixtures (Mk II fixtures; Nobel Biocare AB, Göteborg, Sweden) between the mental foramina, and (3) the patients had to be available for the follow-up and maintenance program. A total of 88 implants were placed in the EG compared to 30 in the RG. In the EG, fixed appliances were connected to the implants within 20 days following implant installation while the fixed appliances in the RG were connected about 4 months following fixture installation. At delivery of the suprastructures, all patients were radiographically examined, an examination that was repeated at the 18- and 60-month follow-ups. RESULTS: The analysis of the radiographs from the EG disclosed that during the observation period, between 18 and 60 months, the mean loss of bone support amounted to 0.2 mm (SD = 0.4). The corresponding value observed in the RG was 0.0 mm (SD = 0.5). During the 60-month observation period, no fixture was lost in any of the two groups examined. The implants under study as well as those in the reference material were at all observation intervals found to be clinically stable. CONCLUSIONS: This clinical study demonstrated that it is, at least based on a 5-year observation period, possible to successfully load via a permanent fixed rigid cross-arch suprastructure titanium dental implants soon after installation. However, such a treatment approach has to be strictly limited to the interforamina area of the edentulous mandible. Furthermore, the bone resorption was found to be within the same range around such implants as around implants installed and loaded according to the original two-stage protocol.

Aged↗
PubMedDate not supplied

Normal anatomy on tomograms for dental implants.

Some dentists may be unfamiliar with reading conventional tomograms made of dental implant sites. The purpose of this article is to aid dentists in identifying normal anatomical landmarks on cross-sectional slices and to correlate them to sagittal slices.

Alveolar Process↗
PubMed1991

Using endosseous dental implants for patients with ectodermal dysplasia.

Congenitally missing teeth and poorly developed or absent alveolar ridges are signs often associated with various types of ectodermal dysplasia. Endosseous dental implants may be used to support fixed mandibular prostheses in patients with ectodermal dysplasia. Anatomical factors and age considerations require careful attention to treatment planning.

Adolescent↗
PubMed1993

[Mandibular fractures following insertion of dental implants].

This article reviews the complications reported in the literature following treatment with dental implants. Special attention is given to mandibular fractures, the conditions leading to the fractures and their management. The authors report on 2 new patients who sustained mandibular fractures and 1 patient who nearly developed a fracture after receiving mandibular endosseous implants.

Aged↗